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NPI Code Detail

MEDICARE: GABRIEL ERIK HANNA PA-C

MEDICARE: GABRIEL ERIK HANNA PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant50.008244RXOH
2363AS0400XSurgical Physician Assistant163552MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164108338
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIEL ERIK HANNA PA-C
Provider Business Mailing Address
First Line : 267 HONEY LN
Second Line :
City : BATTLE CREEK
State : MI
Zip : 49015-3100
Country : US
Telephone Number : 269-589-9791
Fax Number :
Provider Business Practice Location Address
First Line : 18101 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5612
Country : US
Telephone Number : 216-476-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2023
Last Update Date : 06/17/2026

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